LYMPHATIC SURGERY

Precise identification of functional lymphatic vessels and lymph nodes during surgery

FLUORESCENCE IS A MUST FOR THE VISUALIZATION OF THE LYMPHATIC SYSTEM IN THE PREVENTION, DIAGNOSIS UP TO LYMPHATIC SURGERY.

Lymphedema is the most common disease of the lymphatics. Secondary lymphedema (due to surgery) is estimated to be approximalively 10 million people worldwide. Lymphedema can be addressed surgically. Precise identification of functional lymphatic vessels and/or lymph nodes is essential in helping surgeons during procedures.

FLUOBEAM®, a near-infrared fluorescence camera, is a unique tool used to assess and analyse lymphatic drainage, efficiency and dysfunction.

It allows for the precise identification of functional lymphatic vessels before lymphatico-venous anastomosis (LVA), and lymph nodes in lymph node transfer procedures.

FLUOBEAM® IN ACTION

Visualization of lymphatic vessels

During consultation, FLUOBEAM® can be used to image in real time functional superficial lymphatic vessels: to perform early diagnosis of lymphedema, to select the most appropriate treatment (surgical or not), and to plan for post-surgery follow-up.

During surgery, FLUOBEAM® can be used: to identify functional superficial lymphatic vessels that can be used for lymphatico-venous anastomosis (LVA), to avoid the harvesting of lymph nodes that do not drain the resected area by performing a “reverse mapping”, for post-surgery follow-up.

Sentinel node biopsy

Sentinel lymph node (SLN) is the first lymph node that drains the tumour. The SLN procedure aims to detect, dissect and analyse this lymph node.

Indocyanine green fluorescence imaging has recently been introduced as an alternative method to assist surgeons in lymph node dissection procedures. FLUOBEAM® allows the visalization of superficial lymphatic drainage and the detection of sentinel lymph nodes after skin incision for different types of tumours.

Download the LYMPHATIC SURGERY brochure (pdf)

SURGEONS' HONOR

Pr Jaume MASIA

Plastic and Aesthetic Surgery, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

'It is essential to understand how the lymphedema works and so FLUOBEAM® is really key for this kind of information. I just can’t perform lymphatic surgery without fluorescence imaging.'

Dr Charlotte NGO

Gynecological and Breast Cancer Surgery, Hôpital Européen Georges Pompidou, Paris, France

'The ICG for detection of the SLN in early breast cancer is feasible; it is accurate, safe and cheap.'

PUBLICATIONS

> Gray RJ. et al. Features of lymphatic dysfunction in compressed skin tissues – Implications in pressure ulcer aetiology. J Tissue Viability 2016

> Gray RJ. et al. Monitoring contractile dermal lymphatic activity following uniaxial mechanical loading. Medical Engineering and Physics 2016

> Miranda Garcés M. et al. Intratissue lymphovenous communications in the mechanism of action of vascularized lymph node transfer. J Surg Oncol. 2016

> Stoffels I. et al. Evaluation of a radioactive and fluorescent hybrid tracer for sentinel lymph node biopsy in head and neck malignancies: prospective randomized clinical trial to compare ICG-(99m)Tc-nanocolloid hybrid tracer versus (99m)Tc-nanocolloid. Eur J Nucl Med Mol Imaging 2015

> Stoffels I. et al. Intraoperative Fluorescence Imaging for Sentinel Lymph Node Detection: Prospective Clinical Trial to Compare the Usefulness of Indocyanine Green vs Technetium Tc 99m for Identification of Sentinel Lymph Nodes. JAMA Surg. 2015

> Markuszewski M. et al. Comparison of Real-Time Fluorescent Indocyanine Green and (99m)Tc-Nanocolloid Radiotracer Navigation in Sentinel Lymph Node Biopsy of Penile Cancer. Clin Genitourin Cancer 2015

> Polom W. et al. Fluorescent versus radioguided lymph node mapping in bladder cancer. Genitourinary Cancer 2016

> Christensen A. et al. Feasibility of Real-Time Near-Infrared Fluorescence Tracer Imaging in Sentinel Node Biopsy for Oral Cavity Cancer Patients. Ann Surg Oncol. 2016

> Nguyen D.P. et al. A Specific Mapping Study Using Fluorescence Sentinel Lymph Node Detection in Patients with Intermediate- and High-risk Prostate Cancer Undergoing Extended Pelvic Lymph Node Dissection. Eur Urol. 2016